VSA Minister Richinel Brug speaking in Parliament on Wednesday.
~ Involuntary admissions at MHF up by 50% early 2025 ~
PHILIPSBURG--Minister of Public Health, Social Development and Labor VSA Richinel Brug has raised the alarm over a sharp rise in mental health cases among children ages 15 years and under, revealing a 159% increase in treated patients between 2021 and 2024.
“I would like to draw… attention to the fact that there has been a 159% increase in the number of treated patients in this group between 2021 and 2024,” Brug told Parliament on Wednesday, highlighting the need for urgent focus on youth mental health. The figures show that 51 persons under age 15 were treated in 2021, 102 treated in 2022, 108 in 2023 and 132 in 2024.
Brug also revealed that involuntary mental health admissions at Mental Health Foundation (MHF) have already reached 50% of last year’s total within the first four months of 2025.
During a public meeting of Parliament on Wednesday, Brug presented the concerning statistics on involuntary admissions. “For 2025, January, February, March, April, and the first week of May, there were 14 cases; what stands out to me is that this result already reflects 50% of the total for 2024," he said, noting that there had been a total of 28 involuntary admissions in 2024, 35 in 2023, and 29 in 2022.
The Minister also presented figures showing a steady increase in the total number of patients treated by MHF between 2021 and 2024. While the overall increase in patient numbers was gradual, the number of care cases provided, especially for admitted patients, saw a sharp rise. “In 2021, the total care provided amounted to 990 cases. However, this number gradually increased to 1,576 in 2022, to 2,210 in 2023, and 1,705 in 2024, all within a span of just three-quarters of a year,” Brug said. “This rapid growth in care demand highlights a troubling trend.”
The increased demand for mental health services is also reflected in the number of treatments provided to daycare patients, which soared from 2,968 treatments in 2021 to 6,253 in 2024, signalling a significant pressure on available services.
Brug highlighted several challenges that hinder progress in addressing the country’s mental health crisis. “A major challenge is the lack of skilled mental health professionals on the island,” he explained. “This is due to either their unavailability or the slow administrative processes involved in securing employment.” Additionally, he pointed out that the salary offered is not competitive enough to attract qualified professionals to the island.
Another issue raised was the stigma and cultural barriers that prevent many individuals from seeking care. “There is also a lack of sufficient public awareness and prevention programmes, which further exacerbates the situation. Moreover, outdated legislation and policies, or sometimes the complete absence of relevant laws, continue to limit the progress we can make in mental health care.”
Brug also addressed the gap in mental health facilities, pointing out that St. Maarten lacks a proper mental health facility. “Lastly, the absence of a proper mental health facility is a critical gap that needs immediate attention,” he said.
In addition to highlighting these challenges, Brug provided findings from an assessment carried out on behalf of the Ministry regarding the state of mental health on St. Maarten. He pointed out the gaps in mental health care coverage, noting that not all care activities are registered at Mental Health Foundation. “Mental health care is also provided outside the Mental Health Foundation,” he said. “Some mental health services are not available in St. Maarten.”
Minister Brug spoke of the need for a more comprehensive approach to mental health care, citing several reasons behind hidden mental health needs on the island. “The reasons behind the hidden demands are stigma associated with mental health, low literacy about mental health, cultural beliefs that affect help-seeking, lack of qualitative services and choice, poor prevention, and insufficient early detection,” he said. “Practical barriers like patient mobility, work hours, and the lack of reimbursement for certain treatments also contribute to these hidden needs.”
He also touched on the island’s demographic challenges, particularly the over-representation of individuals age 50-60 in the population. “St. Maarten is dealing with an over-representation of people aged 50-60, a small working population base, and a dependence on tourism, which affects its stability,” he said. He also highlighted how migration after natural disasters further reduces the island’s workforce.
Brug pointed out the rising demand for mental health services, particularly following the COVID-19 pandemic. “There has been an increase in both the number of patients and the need for treatments,” he said. “Additionally, there is a higher prescription rate.” He also observed that there has been a noticeable shift toward outpatient and ambulatory care.
The Minister also discussed capacity issues in MHF, noting that it is the island’s main and sole provider of mental health services. “If mental health isn’t an option or funding is an issue, there are long waiting times for treatment,” he said. “There is a shortage of psychiatrists, psychologists, and specific psychiatric beds, which leads to a need for more psychologists, specialised nurses, and dedicated facilities.”
He stressed the importance of modernising legislation to address the growing mental health challenges. “There is a clear need for modernised legislation to address current mental health challenges,” he said. “While there is a positive outlook on community-based approaches, there is a need for more clarity in their implementation.”
He also highlighted the lack of facilities for forensic care, a significant gap in the island’s mental health infrastructure. “There are currently no facilities for forensic care, which creates a significant gap in services,” Brug said. He emphasised the need to improve the mental health facility’s community image to foster trust and engagement with the public.
Brug underscored the urgency of addressing St. Maarten’s mental health challenges. “St. Maarten's mental health services are currently insufficient to meet the growing demands,” he said. “Significant enhancements in staffing, facilities, and public awareness are required to meet future needs and align with international norms.”
